[Tumor of the mesosalpinx with unclear differentiation]

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This paper describes female adnexal tumors of probable Wolffian origin (FATWO), detailing their variable histological patterns, generally benign behavior with rare malignant transformation, and immunohistochemical markers including pancytokeratin, CD10, vimentin, calretinin, and inhibin A.

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The paper reviews and describes female adnexal tumors of probable Wolffian origin (FATWO), rare tumors localized mainly in the broad ligament or mesosalpinx, which can show diverse histologic growth patterns (solid, tubular, cribriform, cystic) despite usually bland cellular morphology and low mitotic rates. It reports that FATWOs are generally benign but can rarely undergo malignant transformation, emphasizing the need for careful examination and surveillance, and it outlines differential diagnostic pitfalls including Sertoli-Leydig cell tumors, metastasized endometrioid carcinoma, and a FATWO-like variant of endometrioid fallopian tube carcinoma. Immunohistochemically, FATWOs express pancytokeratin, CD10, vimentin, calretinin, and inhibin A, with estrogen/progesterone receptor positivity in a minority and no detectable EMA. Relevance to endometriosis: the paper discusses endometrioid carcinoma as a key differential diagnosis (a tumor type often discussed in the endometriosis literature), though it does not explicitly discuss endometriosis or adenomyosis.

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Abstract

Female adnexal tumors of probable Wolffian origin (FATWO) are rare tumors, which are mostly localized in the broad ligament or the mesosalpinx. They show high intratumor and intertumor variability of histological patterns (e.g. solid, tubular, cribriform and cystic) with usually unremarkable cellular and nuclear morphology and a lower mitotic rate. In general, they behave in a benign fashion but there are rare cases with malignant transformation, so that careful examination and surveillance are necessary. Differential diagnoses include Sertoli-Leydig cell tumors, metastasized endometrioid carcinoma and the FATWO-like variant of the endometrioid carcinoma of the fallopian tubes. The FATWOs express pancytokeratin, CD10, vimentin, calretinin and inhibin A. Estrogen and progesterone receptors are expressed in a minority of cases, whereas epithelial membrane antigen (EMA) is not detectable.
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Zusammenfassung „Female adnexal tumors of (probable) wolffian origin“ (FATWOs) sind seltene Tumoren, die meist im Lig. latum uteri oder der Mesosalpinx lokalisiert sind. Sie zeigen eine hohe intra- und intertumorale Variabilität der histologischen Wachstumsmuster (solide, tubulär, kribriform oder zystisch) mit meist blander Zell- und Kernmorphologie bei geringer Mitoserate. In der Regel weisen sie einen benignen Verlauf auf, maligne Krankheitsverläufe sind jedoch möglich, sodass eine Indikation zur sorgfältigen Untersuchung und Nachbeobachtung gegeben ist. Differenzialdiagnostische Pitfalls sind der Sertoli-Leydig-Zell-Tumor, ein metastasiertes endometrioides Karzinom und die FATWO-ähnliche Variante des endometrioiden Tubenkarzinoms. FATWOs exprimieren Panzytokeratin, CD10, Vimentin, Calretinin, Inhibin A und in einigen Fällen den Östrogen- und Progesteronrezeptor, während EMA nicht nachzuweisen ist. Abstract Female adnexal tumors of probable Wolffian origin (FATWO) are rare tumors, which are mostly localized in the broad ligament or the mesosalpinx. They show high intratumor and intertumor variability of histological patterns (e.g. solid, tubular, cribriform and cystic) with usually unremarkable cellular and nuclear morphology and a lower mitotic rate. In general, they behave in a benign fashion but there are rare cases with malignant transformation, so that careful examination and surveillance are necessary. Differential diagnoses include Sertoli-Leydig cell tumors, metastasized endometrioid carcinoma and the FATWO-like variant of the endometrioid carcinoma of the fallopian tubes. The FATWOs express pancytokeratin, CD10, vimentin, calretinin and inhibin A. Estrogen and progesterone receptors are expressed in a minority of cases, whereas epithelial membrane antigen (EMA) is not detectable. Similar content being viewed by others Literatur Devouassoux-Shisheboran M, Silver SA, Tavassoli FA (1999) Wolffian adnexal tumor, so-called female adnexal tumor of probable Wolffian origin (FATWO): immunohistochemical evidence in support of a Wolffian origin. Hum Pathol 30:856–863 Heatley MK (2009) Is female adnexal tumour of probable wolffian origin a benign lesion? A systematic review of the English literature. Pathology 41:645–648 Huang W, Zhao Y, Zhao J et al (2010) Endometrioid carcinoma of the fallopian tube resembling an adnexal tumor of probable wolffian origin: a case of report and review of the literature. Pathol Res Pract 206:180–184 Kariminejad MH, Scully RE (1973) Female adnexal tumor of probable Wolffian origin. A distinctive pathologic entity. Cancer 31:671–677 Ordi J, Romagosa C, Tavassoli FA et al (2003) CD10 expression in epithelial tissues and tumors of the gynecologic tract: a useful marker in the diagnosis of mesonephric, trophoblastic, and clear cell tumors. Am J Surg Pathol 27:178–186 Sheyn I, Mira JL, Bejarano PA et al (2000) Metastatic female adnexal tumor of probable Wolffian origin: a case report and review of the literature. Arch Pathol Lab Med 124:431–434 Zhao C, Bratthauer GL, Barner R et al (2007) Comparative analysis of alternative and traditional immunohistochemical markers for the distinction of ovarian sertoli cell tumor from endometrioid tumors and carcinoid tumor: a study of 160 cases. Am J Surg Pathol 31:255–266 Author information Authors and Affiliations Corresponding author Ethics declarations Interessenkonflikt D. Nann, S. Gahlen, H.G. Keul, H.J. Voigt, F. Fend, A. Staebler geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. Additional information Redaktion C. Kuhnen, Münster Die Autoren D. Nann und S. Gahlen haben zu gleichen Teilen zu dieser Arbeit beigetragen. Rights and permissions About this article Cite this article Nann, D., Gahlen, S., Keul, H.G. et al. Tumor der Mesosalpinx mit unklarer Differenzierung. Pathologe 37, 84–87 (2016). https://doi.org/10.1007/s00292-015-0128-6 Published: Issue date: DOI: https://doi.org/10.1007/s00292-015-0128-6

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Condition tags

endometriosis

MeSH descriptors

Adenoma Adnexal Diseases Adnexa Uteri Cell Transformation, Neoplastic Fallopian Tube Neoplasms Adenoma Adnexal Diseases Adnexa Uteri Adult Cell Transformation, Neoplastic Diagnosis, Differential Endometriosis Endometriosis Fallopian Tube Neoplasms Fallopian Tubes Fallopian Tubes Female Guideline Adherence Humans Hysterectomy

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